“I definitely need a new hip but when I saw the specialist in Gisborne he said he wouldn't touch me until I had given up smoking cigarettes and lost 20 kilograms in weight.”

Kicking the fags was no problem, and Ruby says she’s saved a heap of money, but she’s always been “a big lady”.

Getting down from 128kg was going to be a challenge. “Some people can feel a bit shy about coming along but as soon as they meet [kaiūwhina] Bernie Semau, that all changes. He’s amazing and he keeps such a close eye on us that we don't want to disappoint him.”

GPs refer clients with long-term or chronic health conditions to the Te Karaka or Gisborne Eke Tū programme so they can learn about nutrition and lifestyle choices, and participate in activities like circuit sessions, yoga, swimming and gym workouts.

Eke Tū Kaiāwhina Bernie says for the foreseeable future chronic diseases will be responsible for the greatest number of deaths and disability in this region.

“But it is by no means a future without hope,” he says. “Eke Tū gives referred patients an opportunity to increase fitness, lose weight and improve their overall health.”

Bernie has developed a fun but safe programme, and clients' progress is followed by a nurse offering extra security for those wrestling with chronic health conditions.

"We want to teach our patients, empower them, to take a leading role in their own care,” he says. “It’s about giving them the knowledge, skills and motivation to make gooddecisions in daily life.”

“It's great to see someone like Ruby put in the effort and achieve such great results,” adds Bernie.

After just a few months of attending twice-weekly sessions at Te Karaka's Rangatira Scout Community Hall, Ruby, who used to work in mental health, is already halfway towards her weight loss goal.

She’s optimistic of being hip-ready by summer because at just 65 years of age she’s got more to give she says. She can't wait to get off the crutches and back into what she loves doing.

“I’ve come so far that I know I can lose the rest of the weight and get this hip sorted out.”

“Achieving that would mean the world to me. It would be amazing to get back to the point where I can share my skills in the mental health field and, with Bernie's help, I will definitely get there.”